Dysplasia associated lesion or mass (DALM) in a patient with ulcerative colitis complicated with primary sclerosing cholangitis

The risk of developing neoplasia is significantly increased in patients with long-standing ulcerative colitis. Intraepithelial neoplasia might arise from flat, endoscopically invisible lesions or may appear as DALM. The latter should be separated from adenoma-like mass (ALM), since the two entities require different management. Case report: A 58-year old female patient was diagnosed with ulcerative colitis in 1996, complicated with primary sclerosing cholangitis since 2007. She presented in our clinic in April 2010 with acute cholangitis. ERCP showed a suprapapillary and a hilar bile duct stenosis, but endoscopi…